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Addressing Back Problems Starts With Assessing the Core


Why are we focusing on your core if you’re here for a back problem? This is a question we often hear in physical therapy and with good reason. Wouldn’t you wonder why you were being instructed to strengthen a part of your body that isn’t necessarily where you’re feeling pain or discomfort? When it comes to patients who are here for back pain, part of their treatment plan involves strengthening their core. But why? Let’s talk spinal anatomy, muscular imbalances and posture.  

When patients come in with lower back pain, one of the very first muscle groups assessed is the core. Most lower back injuries occur from unbalanced abdominals and poor lower back mechanics. Overtraining core muscles, but not focusing any energy on the muscles in the back, sets you up for injury. When most people hear the word “core” they immediately think of rock solid abs. A six pack, or eight if you’re lucky, refers to the eight muscles directly in the center of the abdomen, known as the rectus abdominus. In addition to the rectus abdominus, there are three other major core movers:

  • Rectus Abdominus: “the flexor”
  • Obliques: Spine stability, trunk rotation, side-bending
  • Transverse Abdominus: “corset”, the deepest and innermost abdominal musculature, stabilizes the lower spine

All these muscles work together to provide static and dynamic stability for the entire body. When any of the muscles groups is overworked or overstretched, the body’s overall functionality takes a major toll. Imagine a building. Its four walls are supposed to hold up the same amount of weight. Now think about what would happen if one of those pillars lost some strength and wasn’t able to provide the same amount of stability as the others. Big problem! Not only are the other three sides being overworked, meaning they are weakening faster, but now the damaged side is more susceptible to injury. Apply this analogy to your back. When the core muscles are weakened, our spinal alignment is altered, which then changes how the body moves, reacts and absorbs external forces.

That leads me to the next subtopic, posture. As we age, we learn easier ways to complete simple tasks like bending from the hips instead of squatting from the knees to pick something up. Now, add in the fact that the majority of people work at a desk for 40+ hours/week, love looking down at their phone during their free time, and spend hours sitting in traffic, all these factors exacerbate the following postural deficiencies:

  • Slouching
  • Rounded shoulders
  • A weak core
  • Forward head posture

To correct those improper postural mechanics, it’s important to work on core activation. This will not only help address back pain but also help the lower body to remain erect. It also can help straighten the thoracic and cervical spine.

Next up, is core stability while performing functional movements. With a strong core, functional movements are more isolated, more powerful and lead to better performance in day to day activities whether those be functional movements we have to perform or things like sports. Think about throwing a baseball. If a pitcher has a weak core, he is forced to use his entire body to produce additional speed, which in turn uses more energy than generating the power from his arm. When the pitcher is able to control his core, he can provide more control over each phase of the pitch allowing for better speed and placement.

How do weak core muscles impact your lower back? Some of the most common lower back injuries that can occur due to weakened core muscles are muscle sprains or strains, disc bulge or herniation, and spinal misalignment. RULE OF THUMB: Strengthening your core properly will decrease your risk of lower back injuries.

By Cierra Washington, ATC

If you are experiencing any lower back pain or discomfort, Loudoun Sports Therapy Center can help you handle your back pain for good! Call our office TODAY at 703-450-4300. CLICK HERE for more information on common causes of lower back pain. 

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